Depth of response prior to autologous stem cell transplantation predicts survival in light chain amyloidosis.
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
28
04
2020
accepted:
03
11
2020
revised:
25
08
2020
pubmed:
20
11
2020
medline:
9
7
2021
entrez:
19
11
2020
Statut:
ppublish
Résumé
The goal of therapy in AL amyloidosis is to inhibit further production of the amyloidogenic light chains, thereby allowing organ recovery and improving survival. We aimed to assess the impact of depth of hematologic response prior to ASCT on survival. We conducted a retrospective study of 128 newly diagnosed AL amyloidosis patients who received induction prior to ASCT between January 2007 and August 2017 at Mayo Clinic. The overall response rate to induction was 86% (CR 18%, VGPR 31% and PR 38%). With a median follow up of 52 months, the median PFS and OS was 48.5 months and not reached, respectively. Response depth to induction therapy was associated with improved PFS and OS. The median PFS was not reached for patients achieving ≥VGPR prior to ASCT and 34.1 months for patients achieving PR or less (P = 0.0009). The median OS was longer in patients with deeper responses (not reached for ≥VGPR vs. 128 months for PR or less (P = 0.02)). On multivariable analysis, independent predictors of OS were melphalan conditioning dose (RR = 0.42; P = 0.036) and depth of response prior to transplant (RR 0.37; P = 0.0295). Hematologic response prior to transplant predicts improved post transplant outcomes in AL amyloidosis.
Identifiants
pubmed: 33208916
doi: 10.1038/s41409-020-01136-2
pii: 10.1038/s41409-020-01136-2
doi:
Substances chimiques
Melphalan
Q41OR9510P
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
928-935Subventions
Organisme : NCI NIH HHS
ID : P50 CA186781
Pays : United States
Commentaires et corrections
Type : CommentIn
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